Subtle, age-related declines in occupational performance among at-risk older adults may go undetected when assessed solely with self-report measures, potentially leading to missed intervention opportunities. Understanding discrepancies between self-reported and performance-based occupational performance outcomes can inform assessment selection and interpretation. To examine the discrepancies between the two types of measure among community-dwelling older adults at risk for losing independence. Cross-sectional study using secondary data analysis. Seventy-one community-dwelling older adults (M age = 74 yr, SD = 9) who showed muscle weakness and reported difficulty with activities of daily living. Canadian Occupational Performance Measure (COPM) Performance score and Assessment of Motor and Process Skills (AMPS) Motor Skills score were used as outcome measures. Participants were categorized as overestimators if they reported a higher COPM Performance score but had a relatively lower AMPS Motor Skills score and as underestimators if the reverse was true. Participants who overestimated their occupational performance (n = 12, M age = 79 yr, SD = 10 yr) were generally older (Z = 2.91, p = .004) and had poorer physical functioning (Zs = -2.54 to 2.42, all ps < .05) but reported higher satisfaction with their performance (Z = 4.72, p < .001) compared with those who underestimated their performance (n = 20, M age = 69 yr, SD = 7 yr). Use of both self-report and performance-based assessments may be warranted to identify late-life disability, particularly among older adults of advanced age or with declined physical functioning. Plain-Language Summary: Older adults of advanced age or with poor physical functioning may rate their occupational performance differently from how they actually perform everyday activities. This study found that some older adults tend to overestimate their performance, even when their actual performance suggests otherwise. These mismatches between how older people think they are performing and how they actually perform could lead to missed chances for support or intervention if only a self-report measure is used. Using self-report followed by performance-based measures is recommended to identify late-life disability among these older adults.

Regional brain atrophy mediates age effects on words recognition in noise in adults.

Associations between the built environment and body mass index among a residentially stable cohort of mid-older aged adults in Brisbane, Australia (2007-2016).

Mild cognitive impairment (MCI) represents a critical prodromal stage associated with Alzheimer's disease and other age-related neurocognitive conditions in middle-old aging adults, yet research exploring its association with fine motor skill deficits remains relatively limited. This study explores the specific characteristics of fine motor function in middle-old aging adults with MCI using the latest wearable inertial motion capture technology. A computerized system with wearable inertial motion capture technology captured and assessed fine motions. The least absolute shrinkage and selection operator-based machine learning algorithm was utilized to construct a nomogram. The discriminatory ability of the model was determined by calculating the area under the curve. Decision curve analysis, clinical impact curve analysis, and bootstrap validation were used to evaluate and validate the stability of models. A total of 289 participants aged ≥50 were recruited, of which 140 participants experienced MCI. Compared with the control group, patients with MCI showed significantly poorer fine motor performance in hand function assessment tasks. Spearman correlation analysis revealed a stronger correlation between fine motor function and visuospatial/executive function. A multivariable nomogram model based on fine motion parameters showed satisfactory discrimination, with an area under the curve of .773. Decision curve analysis, clinical impact curve analysis, and bootstrap validation demonstrated the good clinical utility and stability of the model. Poor motor functioning was associated with MCI status. The nomogram model, based on fine motion parameters, demonstrated moderate discriminative performance in assessing the risk of MCI, serving as a valuable clinical supplement. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

We investigate whether common circle of Willis (CoW) variants relate to cerebral blood flow (CBF) characteristics among aging adults. Vanderbilt Memory and Aging Project participants free of clinical stroke (n = 390, 71 ± 8 years, 55% male) completed magnetic resonance angiography to assess cerebral artery variants and pseudocontinuous arterial spin labeling to quantify resting CBF and spatial coefficient of variation (sCoV), a marker of perfusion heterogeneity or stability. Linear regression models related categorical variants to regional CBF and sCoV, adjusting for age, sex, race/ethnicity, education, cognitive status, Framingham Stroke Risk Profile, and APOE-ε4 status. Absence of at least one posterior communicating artery (PcoA) related to lower occipital lobe CBF (p = 0.001) and higher global (p = 0.003), temporal (p = 0.001), and occipital lobe sCoV (p = 0.01). Bilateral PcoA absence related to lower global (p = 0.01), parietal (p = 0.01), and occipital lobe CBF (p = 0.0001) and higher global (p < 0.0001), temporal (p < 0.0001), and occipital lobe sCoV (p = 0.0003). Hypoplastic and fetal-type variants did not relate to outcomes (p > 0.22). Findings demonstrate that missing PcoAs influence both perfusion magnitude and efficiency, suggesting that common CoW variants may produce regionally coherent hemodynamic effects in heart-healthy aging adults and represent markers of early cerebrovascular vulnerability.

Dysmorphology examinations have established that fetal alcohol spectrum disorders (FASD) are associated with characteristic physical features from infancy through adolescence. As individuals mature into young adulthood and beyond, the aging process may attenuate characteristic features over time. The purpose of this study was to evaluate FASD-related dysmorphology at midlife. Subjects (N = 192) were recruited from two longitudinal cohorts and from the general community (Mage = 39.5 years, SDage = 8.1 years). A majority (n = 132, 68.8%) had an FASD or well-documented prenatal alcohol exposure (PAE). Standard dysmorphology examinations of 23 physical features were conducted, blind to FASD/PAE status. Participants were stratified into experimental groups according to actual or inferred degree of dysmorphology at the time of their initial examination in childhood or adolescence: high dysmorphology or low dysmorphology. Age-matched controls with no diagnosed or suspected FASD formed the third experimental group. Hierarchical multiple and logistic regression analyses were conducted, regressing the 23 physical characteristics on age, race/ethnicity, and sex (Block 1), experimental group (Block 2), and the two-way interactions between experimental group and the demographic variables (Block 3). Numerous main effects were found for the demographic variables. Controlling for these, main effects for experimental group were found for orbitofrontal circumference, palpebral fissure lengths, philtrum score, vermilion border score, hypoplastic midface, and camptodactyly. Demographics moderated effects of experimental group for philtrum length, philtrum score, and vermilion border score, cardinal features of FASD. Findings indicate that PAE-related dysmorphological features persist into adulthood and further into midlife and may remain useful in diagnosis of FASD beyond young adulthood. However, as demographic factors appear to impact some of the cardinal features of FASD, age-, gender-, and race-related norms and reference image sets for the sentinel features of FASD in adults of different ages may be helpful in diagnosing individuals in adulthood and beyond.

Sarcopenia and osteoporosis are common age-related conditions that lead to frailty, functional decline, and increased fracture risk. Resistance training (RT) improves muscle strength and bone mineral density (BMD), but the optimal training intensity remains unclear. This systematic review and meta-analysis synthesized evidence from randomized controlled trials evaluating high-intensity (≥ 70% one-repetition maximum) versus low-to-moderate-intensity (< 70% one-repetition maximum) RT in older adults (age ≥ 50 years). The review included 18 studies (1283 participants). The primary outcomes were lower limb muscle strength (leg press and leg extension), lumbar spine BMD, and femoral neck BMD. The secondary outcomes were fall incidence and adverse events. Standardized mean differences (SMDs) and risk ratios (RRs) were pooled using a random-effects model. High-intensity RT significantly outperformed low-to-moderate-intensity RT in improving leg press (SMD: 0.95; 95% confidence interval [CI]: 0.48-1.43) and leg extension (SMD: 0.63; 95% CI: 0.09-1.17). No significant between-regimen difference was observed in lumbar spine BMD (SMD: 0.28; 95% CI: -0.02 to 0.58), femoral neck BMD (SMD: 0.13; 95% CI: -0.08 to 0.33), fall incidence (RR: 2.68; 95% CI: 0.65-11.11), or adverse events (RR: 2.42; 95% CI: 0.66-8.88). High-intensity RT outperforms low-to-moderate-intensity RT in improving lower limb muscle strength in older adults. The modalities appear similarly effective in maintaining BMD. No significant between-regimen differences were observed in fall incidence or adverse events, suggesting similar safety profiles. Further randomized controlled trials with well-defined populations and standardized RT protocols are required to validate these findings. International Prospective Register of Systematic Reviews Database: CRD420251076841.

Current understanding of how facial and vocal cues can communicate emotional intent is based on patterns observed in adults, with surprisingly little known about age-related differences in nonverbal expression. Do adolescents and adults use different nonverbal cues to express emotions? This cross-sectional laboratory study revealed age-related differences in how early adolescents (ages 10-11; N = 64), mid-adolescents (ages 12-15; N = 54), and emerging adults (ages 18-25; N = 50) use facial movements and vocal cues to intentionally convey emotions. Adolescents showed lessened use of facial movements linked to prototypical expressions of happiness and fear, and less differentiated facial movements to convey distinct emotions. Early adolescents also spoke louder (particularly to express happiness), slower, and with higher harmonicity than mid-adolescents and emerging adults when expressing emotions. Findings suggest that our understanding of facial and vocal cues involved in emotional expression may not generalize to adolescents, and that nonverbal communication patterns may mature into adult-like forms during adolescence. SUMMARY: Findings from this study indicate that adolescents and emerging adults use different patterns of facial movements and vocal cues to purposefully communicate their emotional intent. The ability to convey emotional intent using nonverbal cues may mature into adult-like forms during adolescence.

Using Kvaal method and machine learning to improve adult dental age estimation with CBCT.

Neural correlates of handgrip strength asymmetry in normal aging and older adults with mild cognitive impairment.

Probiotic supplementation is gaining attention for its role in maintaining health and enhancing the quality of life of the elderly. Leukocyte telomere length (LTL) is a biomarker of cellular aging, with shorter LTL associated with cardiovascular morbidity and mortality. This study explored whether probiotics could counteract LTL attrition in an ethnically homogeneous cohort of older adults over a 6-month period. Samples were selected from the PROBIOSENIOR trial, a randomized, double-blind, placebo-controlled study involving 46 participants (≥60 years). Participants were randomized to receive either SYNBIO® probiotics (5 × 109 CFU/daily dose) or a placebo for 6 months. Genomic DNA was extracted from blood samples at baseline, and 6 months later, LTL measures were obtained via quantitative PCR. A general linear model assessed the "treatment x time" interaction as the main outcome. LTL was successfully assessed for all participants (N = 46 × 2 time points). Statistical analysis revealed a significant "treatment x time" interaction (P = .034), indicating a reduced LTL attrition rate in the probiotic group compared with the placebo group. A 6-month supplementation with SYNBIO probiotics significantly reduced LTL attrition in an ethnically homogeneous cohort of elderly adults. These findings suggest that probiotics may serve as a simple and effective intervention to mitigate cellular aging and promote healthy aging.

The recent document from the American Heart Association updates the guidelines on the diagnosis and management of Kawasaki disease (KD), a severe acute systemic inflammatory and febrile illness with mucocutaneous manifestations and lymph node involvement primarily affecting children under 5 years of age. Coronary artery involvement, with dilation and aneurysms in approximately 25% of patients, and cardiovascular system involvement make KD the most common systemic vasculitides and the leading cause of acquired heart disease in pre-school children living in developed countries. Classic KD is diagnosed based on established clinical and laboratory criteria, which exclude other similar conditions. The etiology and pathogenesis of KD remain unknown, with the disease affecting genetically susceptible children through an immune-mediated mechanism. The leading theory is that an unidentified trigger initiates a multi-organ inflammatory pathological cascade, sometimes resulting in incomplete or atypical forms in younger patients. For this reason, the American guidelines review KD diagnostic criteria, cardiac imaging techniques (echocardiography, coronary computed tomography, magnetic resonance imaging), specific therapies (intravenous immunoglobulin, aspirin, and additional treatments for resistant cases), management of myocardial infarctions, and the transition of care from pediatric to adult age. This review article also highlights future research areas, the role of inflammation, the development of differential diagnostic algorithms for multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection, and the use of new oral anticoagulants. Lastly, the most recent data on the long-term course of the disease and the regression of coronary aneurysms are revisited.

Cannabis use disorder risk among midlife adults reporting medical and nonmedical cannabis use, 2019-2024.

Background: Anaphylaxis is a life-threatening allergic reaction that requires prompt epinephrine and post-treatment management. Guidelines recommend prescribing epinephrine at discharge from the emergency department (ED), yet results of studies show lower-than-recommended prescribing rates and variable ED lengths of stay (LOS). Large-scale analyses of adult anaphylaxis care in U.S. EDs remain limited. Objective: The objective was to estimate the proportion of adults discharged from U.S. EDs with an epinephrine prescription, characterize ED LOS, and identify predictors of these outcomes. Methods: We analyzed 2013-2015 and 2018-2022 National Hospital Ambulatory Medical Care Survey-ED visits for adults ages ≥ 18 years diagnosed with anaphylaxis who were discharged home. Outcomes were (1) epinephrine prescription at discharge and (2) ED LOS < 4 hours. Patients who arrived by emergency medical services (EMS) were excluded for LOS analysis. Multivariable log-binomial regression estimated risk ratios (RR) between outcomes and clinical predictors. Results: Among 609 ED visits, 14% resulted in an epinephrine prescription at discharge (95% confidence interval [CI], 10%-18%). The median (interquartile range) LOS was 138 minutes (80-199 minutes), with 83% discharged within 4 hours (95% CI, 78%-87%). Older adults (≥42 years) and Hispanic patients were less likely to receive an epinephrine prescription (RR 0.47 [95% CI, 0.25-0.90]; RR 0.34 [95% CI, 0.12-0.95], respectively). Rural visits were more likely to have LOS < 4 hours (RR 1.12 [95% CI, 1.02-1.23]). Conclusion: Epinephrine prescribing at discharge was infrequent across the full cohort, whereas ED LOS was typically brief among the patients who did not arrive by EMS. Older adults and Hispanic patients were less likely to receive epinephrine, and rural visits had shorter LOS. These findings highlight potential disparities in discharge prescribing and ED management of adult anaphylaxis in U.S. EDs.

Clostridium perfringens is classified into different types, of which Type D, due to its production of epsilon toxin, can cause enterotoxemia, a fatal disease in ruminants, particularly goats. This study investigated the prevalence, isolation, molecular identification, antibiotic resistance and therapeutic response of C. perfringens Type D in goats from the Peshawar and Charsadda districts of Pakistan. A total of 5000 faecal samples (2500 from each district) were collected from clinically suspected goats and cultured on selective media. Molecular confirmation was performed by PCR targeting the epsilon toxin (etx) gene. Antibiotic susceptibility was assessed via the Kirby-Bauer disc diffusion method. Clinico-therapeutic trials were conducted on 60 affected goats divided into control, parenteral and enteral treatment groups. The prevalence was 400/2500 (16%) in Peshawar and 300/2500 (12%) in Charsadda, with peak occurrences during spring and winter. Isolates showed complete resistance to gentamicin and high resistance to tetracycline and amoxicillin but were largely susceptible to teicoplanin, sulphamethoxazole and trimethoprim. Parenteral antibiotic therapy resulted in significantly higher recovery (80%) than enteral treatment (30%) (p<0.05). Risk factors included adult age, female sex, forage-based feeding and large flock size. These findings underscore the importance of seasonal management, judicious antimicrobial use and vaccination for effective control of C. perfringens Type D in goats.

Vitamins A and D regulate numerous genes through intersecting metabolic pathways, influencing lung development and asthma. This article aimed to examine the impact of vitamins A and D on lung function, epigenetic ageing and regulatory epigenetics in children and adults with asthma. Two asthma cohorts, GACRS (Genetic Epidemiology of Asthma in Costa Rica Study; 1165 children) and ODOLLFA (Omic Determinants of Longitudinal Lung Function in Asthma; 1041 adults) were included. Serum miRNA profiles, blood DNA methylation and plasma/serum vitamin A and D levels were measured. Associations between vitamin levels and lung function (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC), miRNA expression and DNA methylation were evaluated. In adults, mediation analysis assessed whether methylation status and miRNAs mediated the relationship between vitamins and lung function or epigenetic ageing. In children, higher vitamin A was associated with higher FEV1 (β=2.5, p=4.9 × 10-3) and FVC (β=7.6, p=7.7 × 10-14) but lower FEV1/FVC (β=-3.9, p=2.0 × 10-16); vitamin D showed no association. In adults, both vitamins were positively associated with FEV1 (vitamin A: β=4.7, p=9.3 × 10-3, vitamin D: β=0.16, p=8.6 × 10-3) and FVC (vitamin A: β=3.4, p=3.0 × 10-2, vitamin D: β=0.18, p=4.6 × 10-4); only vitamin A was associated with FEV1/FVC (vitamin A: β=2.5, p=3.9 × 10-2). Vitamin D sufficiency corresponded to lower epigenetic ageing in adults. Higher vitamin levels were associated with IRF5 regulatory cytosine hypomethylation at cytosine-guanine dinucleotides (CpG), corresponding to better lung function and lower ageing. Distinct vitamin-associated miRNAs were identified, with shared targets enriched in immune and cell-cycle pathways. Mediation analyses indicated statistical partial effects through methylation and miRNAs. Vitamin A, but not vitamin D, in children was associated with better lung function and lower epigenetic ageing in asthma, with effects mediated by DNA methylation and miRNA regulation.

Arterial stiffness (AS) is a critical pathological basis for major cardiovascular diseases (CVD), with its progression closely associated with modifiable risk factors such as hypertension and dyslipidemia. Remnant cholesterol (RC), a key dyslipidemia indicator, is increasingly recognized for its cardiovascular risk predictive value independent of low-density lipoprotein cholesterol (LDL-C). This study explored the independent and additive interactive associations of hypertension and RC with AS in a Chinese middle-aged and elderly population, so as to provide evidence-based support for the prevention and management of cardiovascular diseases in this high-risk population. A retrospective cohort study was conducted on 6,886 middle-aged and elderly participants (≥ 45years) who underwent health examinations at the Health Management Center of Zigong Fourth People's Hospital from January to December 2023. All participants completed measurements of brachial-ankle pulse wave velocity (baPWV) for AS assessment, blood pressure, blood lipids, and other biochemical indicators. Participants were stratified into the AS group (baPWV ≥ 1800cm/s) and normal group (baPWV < 1800cm/s). Multiple analytical approaches were used to analyze the relationship between hypertension, RC and AS: multivariable logistic regression models (adjusted for age, gender, BMI, smoking history, drinking history, diabetes, and other confounding factors) were applied to evaluate their independent and joint effcets with AS; participants were further divided into four subgroups (low RC without hypertension, high RC without hypertension, low RC with hypertension, high RC with hypertension) to assess the interaction of the two factors on AS risk; additive interaction models were constructed to quantify their additive interaction; restricted cubic spline (RCS) models were used to explore the non-linear relationship between blood pressure and AS risk and to identify apparent inflection points within the study population. Of the 6,886 participants, 4,702 (68.3%) were identified with AS. Both hypertension and elevated RC were independently associated with an increased odds of AS (P < 0.001). Participants with both hypertension and high RC exhibited the highest risk of AS (OR = 3.50, 95% CI: 2.66-4.61) compared to the low RC without hypertension. A additive interaction between hypertension and elevated RC on AS was observed, with the relative excess risk due to interaction (RERI) = 1.21 (95% CI: 0.13-2.23). The RCS model identified apparent inflection points around 127mmHg for systolic blood pressure (SBP) and 84mmHg for diastolic blood pressure (DBP), where the risk of AS appeared to increase more rapidly within the study population. This study identified an additive interaction between hypertension and elevated RC in relation to AS among middle-aged and elderly Chinese adults. These findings suggest that the integrated assessment of hypertension and RC may provide complementary information for identifying individuals at increased risk of AS.

Aging often reduces opportunities for everyday interaction and instrumental support, raising questions about the potential role of artificial intelligence (AI) technologies in later-life well-being. This study examined how AI voice assistants may fulfill, or fall short of, older adults' basic psychological needs through the lens of self-determination theory (SDT). Eighteen U.S.-based community-dwelling older adults (ages 66-85) participated in a two-week AI voice assistant trial and completed daily diaries and pre- and post-intervention surveys. Using mixed methods, qualitative thematic analysis and large language model-assisted content analysis, we analyzed 237 diary entries (1,512 sentences) across three SDT dimensions: autonomy, competence, and relatedness. Findings reveal voice assistants primarily supported autonomy (medication reminders, safety, emotional regulation) and competence (task accomplishment, activity maintenance), with experiences remaining largely consistent across the two-week period. Relatedness responses were the most divided: some participants valued companionship features while others found them inauthentic or uncomfortable. Despite positive daily experiences, loneliness and life satisfaction showed no significant change. These findings suggest that the benefits of AI voice assistants for older adults may be more evident in supporting everyday autonomy and competence than in addressing social isolation, and that psychological benefits of short-term use may not immediately translate into changes in global well-being outcomes.

Cocaine use disorder prevalence is around 2.2% for individuals age 12 and older, with higher rates reaching 6.2% in young adults ages 18-25. In 2021, around 23% of all US overdose deaths were related to cocaine. Cannabis use disorder is more prevalent than cocaine use disorder with prevalence reaching 14.7%. This study aims to evaluate the impact of cocaine and cannabis on clinical cardiovascular outcomes. Specifically, it investigates the incidence of new-onset cardiac arrhythmia between the cocaine and cannabis users, as well as the incidence of cardiac arrest events, major adverse cardiovascular events including myocardial infarction (MI) and stroke, and all-cause mortality. We did a retrospective cohort analysis using the TriNetX database of cocaine and cannabis user patients and created two cohorts: cocaine and cannabis. Propensity score matching was employed to reduce baseline disparities. The primary outcome was the incidence of new-onset cardiac arrhythmia. Secondary outcomes included cardiac arrest events, all-cause mortality, and occurrence of major adverse cardiovascular events (MI and stroke). After matching, 248 769 patients were included in each cohort (cocaine and cannabis users). New-onset cardiac arrhythmia occurred more frequently in the cocaine group (0.2%) compared with the cannabis group (0.15%) (HR: 1.067; 95% CI: 1.022-1.115, P < 0.035). Cocaine use was also associated with higher rates of the secondary outcomes: cardiac arrest (HR: 1.442; 95% CI: 1.346-1.545, P < 0.001), all-cause mortality (HR: 1.215; 95% CI: 1.187-1.243, P < 0.013), and major adverse cardiovascular events (HR: 1.147; 95% CI: 1.116-1.178, P < 0.001). Cocaine users experience significantly higher rates of new-onset cardiac arrhythmias, cardiac arrest, and major adverse cardiovascular events (MI and stroke) compared with cannabis users. These findings highlight the differing outcomes associated with substance use. Future research should aim to validate our findings through prospective, multicentre studies with standardized diagnostic methods as well as longer-term follow-up to more accurately define the outcomes.

Biomarkers of aging, particularly DNA methylation-based clocks, have shown promise as tools to assess whether interventions may impact the rate of biological aging. Among possible interventions physical exercise has shown protective effects against many age-associated diseases, while time-restricted feeding (TRF) has shown metabolic benefits in preclinical models. The combined effect of exercise and TRF on aging biomarkers remains largely unexplored. In this 52-week four-armed, randomized, controlled trial (clinicaltrials.gov: NCT07207044) 240 healthy adults aged 65 and above will be allocated to four groups: combined cardio and strength training (EXE), TRF, combined EXE and TRF, or control. Participants will undergo assessments at baseline, 3, 6, and 12months, with follow-ups at 2, 5, and 10years. The primary outcome measure is Dunedin Pace of Aging DNA methylation age with secondary measures including RNA-sequencing, metabolomics, inflammatory markers, microbiome analysis, cognitive and physical measures. By deeply phenotyping participants, the Fasting And eXercise (FAXAge) study will provide novel insights into whether TRF, EXE, or a combination can slow or reverse biological aging in older adults.